What Does a Sex Therapist Do? Who They Are, What Sessions Look Like, and How to Find One
What does a sex therapist do? Learn who sex therapists are, what happens in a session, what they treat, and how to find a licensed one near you.
General education, not medical advice. If something here worries you, talk with a clinician.
Table of Contents
What does a sex therapist do? A sex therapist is usually a licensed mental health professional who helps people with sexual problems by talking them through. In that way the work looks a lot like ordinary talk therapy for anxiety or depression, with sex as the main subject. Nothing sexual happens in the room. You talk, your therapist asks questions and explains, and any exercises happen later at home.
People go for many reasons. Some have a specific problem, like erectile trouble or pain during sex. Others want help with a desire gap in a relationship, a painful history, or questions about who they are.
This guide explains who sex therapists are and how they are trained. It also covers what sessions are like, when a doctor should be involved too, and how to find a good therapist near you.
Who sex therapists are and how they are trained
A licensed therapist first
Most sex therapists start out as ordinary therapists. They hold a master’s or doctoral degree in psychology, counseling, social work, or marriage and family therapy, and a few come from medicine or nursing. On top of that degree, they take extra training in human sexuality, how the body responds, and how couples work.
That base matters. It means a sex therapist can also treat the anxiety, depression, or relationship strain that often sits underneath a sexual problem. AASECT, the main certifying group in the US, describes its certified sex therapists as licensed professionals trained to give in-depth psychotherapy. They can handle simple concerns and also longer, more complex cases.
Be careful with titles. A sexuality counselor may be a nurse, a school counselor, or a member of the clergy. Counselors like these give short-term advice and are trained to refer people who need deeper therapy elsewhere.
What AASECT certification adds
Certification is a way to check that a therapist trained for this work. According to Sexual Health Alliance, a training provider, AASECT asks for a clinical master’s degree and an independent license to practice therapy. The same source lists 90 hours of sexuality education and 60 hours of sex therapy training. Applicants also need 50 hours of supervision and 300 hours of direct client work in sex therapy.
Certification is voluntary. Plenty of skilled therapists treat sexual concerns without it, and many therapists get little sexuality training in graduate school. So the credential is a helpful shortcut, but you should still ask any therapist how they learned this work.
Sex therapist vs. sexologist vs. sex coach vs. surrogate partner
Search for help and you will see several titles that sound alike. They mean different things, and only some of them involve a license to provide therapy.
| Title | What they do | Licensed to provide therapy? | Physical contact? |
|---|---|---|---|
| Sex therapist | Talk therapy for sexual concerns, with homework done at home | Yes, a licensed mental health professional | Never with the therapist |
| Sexologist | Studies human sexuality, often from a research angle | Not by that title alone | Depends on their other training |
| Sex coach | Practical, goal-focused guidance about your sex life | Typically not licensed | Some coaches use hands-on exercises |
| Surrogate partner | Works with a client as part of a team that includes a licensed or certified therapist | The team therapist is; the surrogate works alongside them | Yes, including sensual and sexual touching |
The table’s practical point is simple. If you want therapy, look for a licensed clinician. A coach may still be useful for some goals, but coaching is not therapy.
Surrogate partner therapy is rare and works differently from regular sex therapy. A client, a therapist, and a surrogate form a three-person team, and the therapist stays involved throughout. A client usually reaches a surrogate through a referral from their therapist.
What problems a sex therapist can help with
Sexual function concerns
If something about sex is causing you distress, it is probably within a sex therapist’s range. The most common problems include erectile dysfunction, early ejaculation, trouble reaching orgasm, and painful intercourse. Low desire and difficulty with arousal are also frequent reasons people book a first session.
You would not be unusual. Cleveland Clinic reports that up to 43% of women and 31% of men have some degree of sexual dysfunction. It also notes that these problems are very treatable. Even when a problem has a medical cause, it often has a mental side too, and that side is what a sex therapist treats.
Relationship, identity, and history
Plenty of people come with no “dysfunction” at all. Couples often arrive because one partner wants sex more than the other. Others have never learned to talk about sex, even after many years together.
Sex therapists also help with relationship damage, such as infidelity or broken trust, that has spilled into the bedroom. Some clients want support with sexual orientation or gender identity. Others are healing from past sexual abuse or trauma.
There are also the less obvious reasons. A person with little experience may want help with fear and nerves before a first relationship. Someone else may want to understand compulsive porn use or sexual behavior that feels out of control. You do not need a diagnosis to ask for help. Distress, confusion, or simple curiosity is enough.
What happens in a sex therapy session
A sex therapy session looks like any other therapy session. You sit and talk with the therapist, alone or with a partner. Nobody undresses, and nothing sexual happens in the room.
The first session: questions and history
The first visit is mostly about getting to know you. Expect questions about what brings you in, your sexual history, your beliefs about sex, and your relationship. Health conditions and medications can affect desire and function, so be ready to mention them too.
You can come alone or as a couple, and your therapist can help you decide which fits your problem. People healing from sexual trauma are often advised to start with individual therapy. Some couples therapists also see each partner alone for part of the work.
Later sessions and homework
Once the therapist understands the problem, the work gets more specific. You may get plain facts about sex and bodies, from anatomy to the stages of sexual response. Part of that job is correcting myths and bad information. You may also practice talking about sex with your partner in a calmer way.
Between visits, the therapist will often give you exercises to do at home. Examples include communication exercises, mindfulness to stay present during sex, and gradual steps for people with anxiety or trauma. How long this takes varies. HealthyWomen reports that sex therapy usually lasts from a few months to a few years.
Sensate focus, a common assignment
Sensate focus is a set of touch exercises that comes from the work of Masters and Johnson. Partners take turns giving and receiving touch without the goal of sex or orgasm, which sounds odd at first but is exactly the point. The steps build one on another over time.
Why does this help? Performance pressure and stress can block arousal, and these exercises take the pressure off. Sex therapists use the method for erectile problems, pain, rapid ejaculation, and low desire. You do the exercises in private at home, not in the office.
What never happens in the room
A sex therapist will never touch you sexually, ask you to undress, or have you perform sexual acts in a session. Real sex therapists do not encourage any sexual activity during a session. If a therapist ever suggests otherwise, end the session and report them to their state licensing board.
When to see a doctor as well as a therapist
For many problems, the best plan is both. A doctor checks for physical causes, and a sex therapist handles the thoughts, feelings, and relationship patterns around them. The International Society for Sexual Medicine suggests a full physical checkup before or alongside sex therapy, because some sexual problems have medical causes.
Physical causes worth ruling out
Erection problems are the clearest example. Many men with diabetes or heart disease have erectile dysfunction. In studies of men with type 2 diabetes, erection problems usually appeared more than three years before signs of heart disease. That makes new erection trouble worth mentioning to a doctor, even if you suspect stress.
Medications are another common cause. Some antidepressants can lower desire and make arousal or orgasm harder, and a change of medication may help. Women can also have poor lubrication after menopause, which a doctor can treat. Cleveland Clinic advises seeing a provider when a sexual problem lasts three months or longer.
Team care for pain
Pain during sex may need more than talk. Pelvic floor physical therapists treat the muscles and tissues of the pelvis. They can relax tight muscles, work on scar tissue, and suggest more comfortable positions.
A sex therapist adds the other half of the work. They help you work through the thoughts and feelings that get in the way of pleasure. They may also talk through less painful positions and how to communicate in the moment. If you see both kinds of specialist, ask whether they can share notes with your permission.
How to find a qualified sex therapist
Finding a good fit takes a few steps: search, check credentials, ask questions, and sort out cost. Most people talk to more than one therapist before choosing, and that is normal.
Where to look
- Start with the AASECT directory. You can search it for certified sex therapists near you. AASECT also certifies sexuality educators and counselors, whose training is different, so check that each listing says sex therapist. You should end up with a short list of names near you.
- Widen the search with a general directory. Psychology Today lets you filter therapists by sex therapy as a specialty. This adds people who treat sexual concerns but never pursued certification.
- Ask your doctor for a referral. A doctor’s referral is one of the best routes in, and it pairs well with a checkup.
- Check the license. Look the therapist up on the site of the state board that issued their license, since boards offer online lookup tools. If the name does not show up, keep looking.
Questions to ask in the first call
Many therapists offer a short phone call before you book. Use it. A good sex therapist will answer your questions about how therapy works and will not be shy about the topic.
Ask these:
- What license do you hold, and what training have you had in sex therapy?
- Have you treated problems like mine before?
- Do you see couples, individuals, or both?
- Do you offer online sessions?
Then notice how you feel. Trust matters in all therapy, and even more when the subject is this personal. If something feels off, try the next name on your list.
Cost, insurance, and telehealth
There is no separate price list for sex therapy, so the best guide is the cost of therapy in general. Project Healthy Minds puts the usual cost of therapy at $90 to $300 or more per session without insurance. With insurance, most people pay $20 to $50 per session. Those figures cover therapy in general, not sex therapy alone, so ask each therapist for their fee.
Project Healthy Minds credits two federal laws for insurance coverage of therapy: the Affordable Care Act and the Mental Health Parity Act. Coverage still depends on your plan, and in-network therapists cost less. Call your insurer and ask about copays, deductibles, and session limits before your first visit. If the therapist you want is out of network, ask whether your plan pays back part of those visits.
Online sessions widen your choices, which helps if few specialists practice nearby. Licensing is handled state by state, so ask whether the therapist is licensed where you live.
Frequently asked questions
Can a sex therapist prescribe medication?
Usually not. Most sex therapists are psychologists, counselors, social workers, or family therapists, and their work is talk therapy. A small number hold medical or nursing degrees. If you need a drug such as sildenafil (Viagra), or a change to a current medication, a doctor handles that part. Many people see a doctor and a sex therapist at the same time.
What’s the difference between a sex therapist and a sexologist?
A sex therapist is a licensed clinician who treats clients. A sexologist studies human sexuality, often as a researcher. Some people are both, but the title “sexologist” alone does not mean the person can provide therapy. If you want treatment, check for a mental health license.
What happens at a sex therapy session?
You talk. The therapist asks about your concerns, history, and relationship, then offers information and exercises to try at home. Nothing physical happens with the therapist, and you keep your clothes on. Sessions can be solo or with a partner, depending on what you want to work on.
What kind of therapist for intimacy issues?
A sex therapist is the best match when the trouble involves sex itself, such as desire, arousal, or pain. Sex therapists also help couples who struggle to talk about sex, or whose trust problems have spilled into their sex life. Cleveland Clinic notes that many sex therapists are also good marriage counselors. If the main issue is general conflict, a couples therapist with sexuality training can also work.
Do I need to bring my partner?
No. People see sex therapists by themselves or with a partner, and both are common. You can also start alone and invite a partner later. If your partner is unwilling, solo sessions can still help you understand what you want.
The bottom line
A sex therapist is a licensed therapist with extra training in sexuality. The work happens through conversation, education, and private exercises at home, and never through sexual activity in the session. They help with sexual function problems, desire gaps, painful history, and questions about identity, for individuals and couples alike.
Sexual problems are common and treatable, so asking for help is a reasonable step. Book a checkup if a physical cause is possible. Then search the AASECT directory or a therapist directory, check the license, and set up a short call with two or three therapists. The right one will make the topic feel ordinary to talk about.
Related reading
- What Is a Healthy Sex Life? Communication, Satisfaction, Safety and Choice
- What Is Sexual Arousal?
- What Is Sexual Pleasure?
- What Is Asexuality? Meaning, Spectrum, Myths and Research
Sources
- Find a Sex Therapist - Psychology Today
- What Actually Happens in Sex Therapy? - HealthyWomen
- Certification Types: Distinguishing Sexuality Educators, Counselors, and Therapists - American Association of Sexuality Educators, Counselors and Therapists (AASECT)
- How Do You Become a Certified Sex Therapist? - Sexual Health Alliance
- What Is A Sex Therapist? Understanding Sex Therapy And Mental Health - BetterHelp
- Types of Sex Therapy - The Couples Center
- What is Surrogate Partner Therapy? - International Professional Surrogates Association (IPSA)
- Sexual Dysfunction: Disorders, Causes, Types & Treatment - Cleveland Clinic
- What are sex therapists? What do they do? How does one choose a sex therapist? - International Society for Sexual Medicine (ISSM)
- Sensate Focus in Sex Therapy: Unlocking Pleasure, Safety, and Connection - American Association of Sexuality Educators, Counselors and Therapists (AASECT)
- Erectile Dysfunction May Signal a Broken Heart - American College of Cardiology
- Pelvic Pain & Intimacy: How Pelvic Floor Therapy Can Help - ATL Pelvic Health
- How to verify licensure - Multi-Discipline Licensure Resource Project
- How Much Does Therapy Cost in 2025? - Project Healthy Minds